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2021 MIPS IA_PSPA_16: Use of decision support and standardized treatment protocols

Activity ID

IA_PSPA_16

Activity Weighting

Medium

Subcategory Name

Patient Safety and Practice Assessment

Activity Description

Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

Objective

Help eligible clinicians align diagnoses and treatment plans with up-to-date, evidence-based standards and guidelines as part of routine care, thus improving the appropriateness of the care they provide and the health outcomes of their patients.

Suggested Documentation

Documented use of decision support and standardized treatment protocols to manage team workflows to meet patient needs. Include the following element:

1) Use of decision support and standardized treatment protocols – Documentation (e.g., checklist, order set, algorithm, screenshot) demonstrating use of decision support and standardized treatment protocols to manage team workflows to meet patient needs. May include use of artificial intelligence/machine learning.

Example/Information

An eligible clinician group, through peer review, determines that there is significant variability in clinical decision-making for a specific condition. They all agree that standardization of practice is best for patient outcomes. Examples of scenarios:

• Emergency Department (ED) treatment of ST elevation Myocardial Infarction (MI): ED staff develop MI standardized orders (order-set) built into the electronic health record (EHR) workflow. The order-set drives specific evaluation and treatment decisions and automatically pages the cardiac catheterization lab and the on-call cardiologist.
• Pediatrics primary care office treatment of subcutaneous/skin abscess: Through discussion among peers in a small pediatrics office, the eligible clinicians determine that there is variability in the decision to implement an abscess incision and drainage versus only using antibiotics and there is also variability in the antibiotic used. As a result, they created internal guidelines on how to approach skin infections and antibiotic treatment and, in particular, addressing methicillin-resistant staphylococcus aureus (MRSA).
• Opiate prescribing: An eligible general surgeon group completed an internal review of opiate prescribing and learned that there was opportunity to reduce the use of opiates significantly. As a result, they created an order-set within their EHR. The use of the order-set was mandatory for all opiate prescribing and created limits for quantity based on condition. The prescribing surgeon could always make an independent treatment decision as needed.

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